Sclerosing mesenteritis is a rare condition that affects the gastrointestinal system. While it can often be managed effectively without a serious impact on a person's life, severe cases may require surgery. Though medical knowledge of the disease has increased significantly with advances in imaging technology, there is still a lot doctors do not know about sclerosing mesenteritis.
Sclerosing mesenteritis is a rare condition diagnosed in only 0.6% of the population. It affects the mesentery, the tissue membrane that surrounds and stabilizes the small intestine. The disease occurs when the membrane becomes inflamed and hardens with scar tissue. Most diagnoses of sclerosing mesenteritis are in middle-aged people, but it can develop in people of any age, including children.
Sclerosing mesenteritis was first discovered in 1924 and given the name retractile mesenteritis. At this time, there was little known about the disease. Over the next decades, doctors assumed it was an early stage of other conditions, such as Whipple disease. It was clearly defined as a disease itself in the 1960s, through the work of William W. Ogden and his series of case studies. Knowledge and understanding have continued to grow, thanks in part to advances in diagnostic imaging.
Due to the evolving understanding of the disease, sclerosing mesenteritis has been referred to by several names. From retractile mesenteritis, it adopted other names including mesenteric panniculitis, mesenteric fibrosis, and mesenteric lipodystrophy. "Sclerosing" means the hardening of tissue. Sclerosing mesenteritis, then, refers to the hardening of the mesentery tissue.
Despite being identified almost 100 years ago, the exact cause of sclerosing mesenteritis is unknown. There are different theories about what leads to the disease, but none are thoroughly established. While sclerosing mesenteritis is not a hereditary disease, experts propose several other factors shown to increase one's chances of developing it.
Several risk factors increase a person's chance of developing sclerosing mesenteritis. The most common is previous abdominal surgery or trauma. Having an autoimmune condition can also raise the risk as it can prompt the immune system and the white blood cells to see parts of the small bowel as invaders and attack. Cancer or a history of cancer also increases the risk of developing sclerosing mesenteritis.
The symptoms of sclerosing mesenteritis primarily affect the abdomen and gastrointestinal system, causing abdominal pain, nausea, and vomiting. Diarrhea, constipation, and weight loss often occur, as well. If the hardened tissue forms a mass surrounding the intestine, the abdomen may become distended, and the mass may be seen and felt externally. Severe cases can lead to blockages in the digestive tract. However, some people with sclerosing mesenteritis never experience any symptoms.
Symptomatic sclerosing mesenteritis requires medical attention and treatment. A physical exam and one or more diagnostic imaging tests usually confirm the diagnosis. In the physical exam, the doctor will check for tenderness, distension, and the presence of a mass in the bowels. The doctor will also conduct a medical history. In most cases, more extensive tests are required to confirm the diagnosis.
Imaging tests confirm the diagnosis of sclerosing mesenteritis by identifying hardened mesentery tissue. The most commonly used method is the computed tomography or CT scan. Some doctors may also use an MRI or abdominal ultrasound. In rare cases, he or she will perform a biopsy of the tissue mass.
Treatment of sclerosing mesenteritis depends on the severity of the condition and primarily addresses the symptoms rather than the disease itself. In some cases, if the symptoms are not having a noticeable effect on the person's everyday life, doctors may determine that no treatment is necessary. In other cases, they may prescribe medication to relieve inflammation, as well as hormone therapy. If the mass of hardened tissue creates a blockage in the bowel, the patient will require surgery.
Like treatment, the outcome of sclerosing mesenteritis depends on the severity of the condition. In less severe cases, the disease may resolve on its own. Most people, however, require medication to manage their symptoms, and often stay on it for the long-term, to prevent a recurrence. With proper medical care, people with sclerosing mesenteritis can expect to lead normal, healthy lives.
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